Impacts of Stressful Life Events and Traumatic Experiences on Onset of Obsessive-Compulsive Disorder.

Keitaro Murayama,Sae Tsuruta,Suguru Hasuzawa,Shigenobu Kanba,Kenta Kato,Hirofumi Tomiyama,Taro Mizobe,Tomohiro Nakao,Aikana Ohno

doi:10.3389/fpsyt.2020.561266

Keitaro Murayama, Sae Tsuruta + Show 7 more

Open Access

https://doi.org/10.3389/fpsyt.2020.561266

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Abstract

Not a few patients with obsessive-compulsive disorder (OCD) have experienced events that affected the onset. The onset of OCD is not limited to the original meaning of trauma; rather, traumatic experiences such as unexpected exposure to contaminants or various stressful life events often cause the onset of OCD. It would be useful to understand the experiences surrounding the onset, including stressful life events and traumatic experiences, for comprehension of the pathophysiology of OCD. In the present study, we investigated the onset conditions of 281 patients with OCD and compared clinical characteristics among groups with or without stressful life events including traumatic experiences. As a result, 172 (61.2%) participants had experienced various stressful life events, and 98 (34%) participants had had traumatic experiences before the onset. Furthermore, the participants who had had stressful life events showed more contamination/fear symptoms compared with those without such life events. Meanwhile, the patients who had had specific traumatic experiences showed a tendency toward hoarding obsessions. To comprehend the pathophysiology of OCD, it is important to understand the stressful life events that precede its onset.

Highlights

Obsessive-compulsive disorder (OCD) is characterized by persistent intrusive thoughts and repetitive actions, significantly affecting the patient’s daily life
The participants were divided into two groups including a stressful life event-related OCD group (LE-OCDs) and a spontaneous-onset OCD group (Sp-OCDs) based on the presence or absence of stressful life events
We identified a subgroup of the LE group having traumatic experiences within 1 month before the onset (TE-OCDs)

Summary

Introduction

Obsessive-compulsive disorder (OCD) is characterized by persistent intrusive thoughts and repetitive actions, significantly affecting the patient’s daily life. There is a difference in onset peaks between males and females, with male patients having the peak in the mid-teenage years and female patients in the mid-twenties This suggests that male OCD is affected strongly by genetic factors and comorbid neurodevelopmental disorders such as tic and autistic spectrum disorders, while female OCD is influenced by comorbid mood or anxiety disorders and life events such as marriage, pregnancy, and childbirth [1]. From the aspect of cognitive behavioral theory, patients with OCD were fear conditioned by stimulants typical of the subject of the obsession at its onset. Their avoidant behaviors, including compulsions, were maintained because those behaviors temporally alleviated their anxieties and fears. Mowrer described this process as a “two-process theory of learning” [2]

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Conclusion